title: Self-collected versus clinician-collected sampling for sexually transmitted infections: a systematic review and meta-analysis protocol.
abstract: BACKGROUND
  Three meta-analyses and one systematic review have been conducted on the question of whether self-collected specimens are as accurate as clinician-collected specimens for STI screening. However, these reviews predate 2007 and did not analyze rectal or pharyngeal collection sites. Currently, there is no consensus on which sampling method is the most effective for the diagnosis of genital chlamydia (CT), gonorrhea (GC) or human papillomavirus (HPV) infection. Our meta-analysis aims to be comprehensive in that it will examine the evidence of whether self-collected vaginal, urine, pharyngeal and rectal specimens provide as accurate a clinical diagnosis as clinician-collected samples (reference standard).
  
  
  METHODS
  
  
  
  METHODS
  Eligible studies include both randomized and non-randomized controlled trials, pre- and post-test designs, and controlled observational studies.
  
  
  METHODS
  The databases that will be searched include the Cochrane Database of Systematic Reviews, Web of Science, Database of Abstracts of Reviews of Effects (DARE), EMBASE and PubMed/Medline.
  
  
  METHODS
  Data will be abstracted independently by two reviewers using a standardized pre-tested data abstraction form. Heterogeneity will be assessed using the Q2 test. Sensitivity and specificity estimates with 95% confidence intervals as well as negative and positive likelihood ratios will be pooled and weighted using random effects meta-analysis, if appropriate. A hierarchical summary receiver operating characteristics curve for self-collected specimens will be generated.
  
  
  CONCLUSIONS
  This synthesis involves a meta-analysis of self-collected samples (urine, vaginal, pharyngeal and rectal swabs) versus clinician-collected samples for the diagnosis of CT, GC and HPV, the most prevalent STIs. Our systematic review will allow patients, clinicians and researchers to determine the diagnostic accuracy of specimens collected by patients compared to those collected by clinicians in the detection of chlamydia, gonorrhea and HPV.
authors.affiliation: BC Centre for Disease Control, 655 West 12th Avenue, Vancouver, BC V5Z 4R4, Canada. Carole.Lunny@bccdc.ca.
authors.forename: Darlene
authors.initials: D
authors.lastname: Taylor
authors.forename: Carole
authors.initials: C
authors.lastname: Lunny
authors.forename: Tom
authors.initials: T
authors.lastname: Wong
authors.forename: Mark
authors.initials: M
authors.lastname: Gilbert
authors.forename: Neville
authors.initials: N
authors.lastname: Li
authors.forename: Richard
authors.initials: R
authors.lastname: Lester
authors.forename: Mel
authors.initials: M
authors.lastname: Krajden
authors.forename: Linda
authors.initials: L
authors.lastname: Hoang
authors.forename: Gina
authors.initials: G
authors.lastname: Ogilvie
mesh_terms: D005260:Female; D006801:Humans; D008297:Male; D015201:Meta-Analysis as Topic; D010614:Pharynx / Q000382:microbiology; D012007:Rectum / Q000382:microbiology; D012107:Research Design; D012648:Self Care; D012749:Sexually Transmitted Diseases / Q000175:diagnosis* / Q000382:microbiology / Q000652:urine; D013048:Specimen Handling / Q000379:methods* / Q000592:standards; D000078202:Systematic Reviews as Topic; D014621:Vagina / Q000382:microbiology